| NPI | 1356906002 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: NJ 25MA12189100) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 69945) |
| Enumeration Date | 2019-05-08 |
| Last Update Date | 2024-06-05 |